Kirvelä M, Olkkola K T, Rosenberg P H, Yli-Hankala A, Salmela K, Lindgren L
Department of Anaesthesiology, Helsinki University Central Hospital, Finland.
Br J Anaesth. 1992 Feb;68(2):178-82. doi: 10.1093/bja/68.2.178.
The pharmacokinetics of an i.v. bolus of propofol 2 mg kg-1 were studied in 10 uraemic patients undergoing renal transplantation and in seven healthy controls matched for age, weight and duration of anaesthesia. Haemodynamic changes during induction of anaesthesia were recorded in the uraemic and in 10 healthy control patients. Pharmacokinetic variables were similar in uraemic and control patients; mean elimination half-lives were 1638 (SD 340) min and 1714 (842) min, respectively. Induction of anaesthesia with propofol was preceded by fentanyl 3 micrograms kg-1. After administration of propofol over 60 s, systolic arterial pressure decreased by 19 (12)%, and by 24 (11)% in the adequately volume loaded uraemic and healthy patients, respectively. Propofol caused a marked peripheral vasodilatation in all patients. A moderate increase in systolic arterial pressure after intubation was statistically significant only in the control patients (P less than 0.01). We conclude that, in terms of pharmacokinetics and haemodynamic changes, propofol may be used safely for the induction of general anaesthesia in uraemic patients.
对10例接受肾移植的尿毒症患者及7例年龄、体重和麻醉持续时间相匹配的健康对照者，研究了静脉注射2mg/kg丙泊酚的药代动力学。记录了尿毒症患者及10例健康对照患者麻醉诱导期间的血流动力学变化。尿毒症患者和对照患者的药代动力学变量相似；平均消除半衰期分别为1638（标准差340）分钟和1714（842）分钟。丙泊酚麻醉诱导前先给予3μg/kg芬太尼。在60秒内给予丙泊酚后，收缩压分别下降了19（12）%，在容量充足的尿毒症患者和健康患者中分别下降了24（11）%。丙泊酚在所有患者中均引起明显的外周血管扩张。插管后收缩压的适度升高仅在对照患者中具有统计学意义（P<0.01）。我们得出结论，就药代动力学和血流动力学变化而言，丙泊酚可安全用于尿毒症患者的全身麻醉诱导。
